Association of nocturnal arrhythmias with sleep-disordered breathing: The sleep heart health study

Reena Mehra, Emelia J. Benjamin, Eyal Shahar, Daniel J. Gottlieb, Rawan Nawabit, H. Lester Kirchner, Jayakumar Sahadevan, Susan Redline

Research output: Contribution to journalArticle

715 Citations (Scopus)

Abstract

Rationale: Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development. Objective: We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing. Methods: The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index ≥ 30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index < 5). Results: Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9% (p = 0.003) for atrial fibrillation; 5.3 versus 1.2% (p = 0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5% (p = 0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p < 0.0003) considered as a continuous outcome. Conclusions: Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.

Original languageEnglish (US)
Pages (from-to)910-916
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume173
Issue number8
DOIs
StatePublished - Apr 15 2006
Externally publishedYes

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Sleep Apnea Syndromes
Cardiac Arrhythmias
Sleep
Health
Ventricular Tachycardia
Atrial Fibrillation
Odds Ratio
Confidence Intervals
Body Mass Index
Ventricular Premature Complexes
Sympathetic Nervous System
Coronary Disease

Keywords

  • Arrhythmia
  • Cohort studies
  • Epidemiology
  • Sleep apnea syndromes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Association of nocturnal arrhythmias with sleep-disordered breathing : The sleep heart health study. / Mehra, Reena; Benjamin, Emelia J.; Shahar, Eyal; Gottlieb, Daniel J.; Nawabit, Rawan; Kirchner, H. Lester; Sahadevan, Jayakumar; Redline, Susan.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 173, No. 8, 15.04.2006, p. 910-916.

Research output: Contribution to journalArticle

Mehra, Reena ; Benjamin, Emelia J. ; Shahar, Eyal ; Gottlieb, Daniel J. ; Nawabit, Rawan ; Kirchner, H. Lester ; Sahadevan, Jayakumar ; Redline, Susan. / Association of nocturnal arrhythmias with sleep-disordered breathing : The sleep heart health study. In: American Journal of Respiratory and Critical Care Medicine. 2006 ; Vol. 173, No. 8. pp. 910-916.
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AU - Mehra, Reena

AU - Benjamin, Emelia J.

AU - Shahar, Eyal

AU - Gottlieb, Daniel J.

AU - Nawabit, Rawan

AU - Kirchner, H. Lester

AU - Sahadevan, Jayakumar

AU - Redline, Susan

PY - 2006/4/15

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N2 - Rationale: Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development. Objective: We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing. Methods: The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index ≥ 30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index < 5). Results: Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9% (p = 0.003) for atrial fibrillation; 5.3 versus 1.2% (p = 0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5% (p = 0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p < 0.0003) considered as a continuous outcome. Conclusions: Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.

AB - Rationale: Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development. Objective: We postulate that the prevalence of nocturnal cardiac arrhythmias is higher among subjects with than without sleep-disordered breathing. Methods: The prevalence of arrhythmias was compared in two samples of participants from the Sleep Heart Health Study frequency-matched on age, sex, race/ethnicity, and body mass index: (1) 228 subjects with sleep-disordered breathing (respiratory disturbance index ≥ 30) and (2) 338 subjects without sleep-disordered breathing (respiratory disturbance index < 5). Results: Atrial fibrillation, nonsustained ventricular tachycardia, and complex ventricular ectopy (nonsustained ventricular tachycardia or bigeminy or trigeminy or quadrigeminy) were more common in subjects with sleep-disordered breathing compared with those without sleep-disordered breathing: 4.8 versus 0.9% (p = 0.003) for atrial fibrillation; 5.3 versus 1.2% (p = 0.004) for nonsustained ventricular tachycardia; 25.0 versus 14.5% (p = 0.002) for complex ventricular ectopy. Compared with those without sleep-disordered breathing and adjusting for age, sex, body mass index, and prevalent coronary heart disease, individuals with sleep-disordered breathing had four times the odds of atrial fibrillation (odds ratio [OR], 4.02; 95% confidence interval [CI], 1.03-15.74), three times the odds of nonsustained ventricular tachycardia (OR, 3.40; 95% CI, 1.03-11.20), and almost twice the odds of complex ventricular ectopy (OR, 1.74; 95% CI, 1.11-2.74). A significant relation was also observed between sleep-disordered breathing and ventricular ectopic beats/h (p < 0.0003) considered as a continuous outcome. Conclusions: Individuals with severe sleep-disordered breathing have two- to fourfold higher odds of complex arrhythmias than those without sleep-disordered breathing even after adjustment for potential confounders.

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